A new study has shown a relationship between the levels of a gut-homing protein called alpha-4 beta-7 occurring at the time of HIV infection and health outcomes in people. The study, led by researchers at the Centre for the AIDS Programme of Research in South Africa (CAPRISA), was published this week in Science Translational Medicine.

Gut-specific homing is the mechanism by which activated T cells target regions of the gut in order to provide an effective immune response. The new study found that women in whom a greater proportion of CD4+ T immune cells expressed alpha-4 beta-7 were more likely to become infected with HIV, and the virus damaged their immune systems more rapidly, than women with lower levels of the protein expression.

Examining the impact of the initial stages of HIV infection on CD4+ T cells expressing alpha-4 beta-7 revealed that HIV targets these cells very early in infection, particularly in the gut. The researchers looked at data from MHRP’s RV254 clinical trial at the Thai Red Cross in Bangkok, Thailand and found that starting antiretroviral therapy (ART) right after HIV diagnosis did not prevent the depletion of CD4+ T cells from the gut or facilitate reconstitution of the depleted cells.

“These findings suggest that interventions in addition to ART may be needed to restore CD4+ T cells in the GI tracts of people living with HIV,” said Dr. Lyle McKinnon one of CAPRISA’s lead researchers on the study. “One such intervention could be an anti-alpha-4 beta-7 antibody called vedolizumab, which is FDA-approved for the treatment of ulcerative colitis and Crohn’s disease.”

MHRP’s acute infection cohort, RV254/SEARCH010, is a collaboration with the Thai Red Cross AIDS Research Centre aimed at identifying acutely infected individuals and place them onto ART immediately. The ongoing study provides insight into crucial stages of early HIV infection.

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